Clarifying values: an updated review

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  • Fagerlin, Angela
    • Other Affiliation: Department of Internal Medicine and Center for Bioethics and Social Sciences in Medicine, University of Michigan and VA Ann Arbor Center for Clinical Management Research, Ann Arbor, USA
  • Pignone, Michael
    • Affiliation: School of Medicine, Department of Medicine
  • Abhyankar, Purva
    • Other Affiliation: Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
  • Col, Nananda
    • Other Affiliation: Departments of Family Medicine and Geriatric Medicine, College of Osteopathic Medicine and Center for Excellence in the Neurosciences, University of New England, Biddeford, USA
  • Feldman-Stewart, Deb
    • Other Affiliation: Division of Cancer Care and Epidemiology, Cancer Research Institute, Department of Oncology, Queen’s University, Kingston, Canada
  • Gavaruzzi, Teresa
    • Other Affiliation: Department of Developmental Psychology and Socialization, University of Padova (Italy), Padova, Italy; Leeds Institute of Health Sciences, Charles Thackrah Building, University of Leeds, Leeds, England
  • Kryworuchko, Jennifer
    • Other Affiliation: University of Saskatchewan College of Nursing, St. Andrew’s College, Saskatoon, Canada
  • Levin, Carrie A
    • Other Affiliation: Informed Medical Decisions Foundation, Boston, USA
  • Pieterse, Arwen H
    • Other Affiliation: Department of Medical Decision Making, Leiden University Medical Center, The Netherlands
  • Reyna, Valerie
    • Other Affiliation: Center for Behavioral Economics and Decision Research and Cornell Magnetic Resonance Imaging Facility, Cornell University MVR B44, Ithaca, USA
  • Stiggelbout, Anne
    • Other Affiliation: Department of Medical Decision Making, Leiden University Medical Center, The Netherlands
  • Scherer, Laura D
    • Other Affiliation: Department of Psychological Sciences, University of Missouri-Columbia, Columbia, USA
  • Wills, Celia
    • Other Affiliation: The Ohio State University College of Nursing, Columbus, USA
  • Witteman, Holly O
    • Other Affiliation: Office of Education & Continuing Professional Development and Department of Family and Emergency Medicine, Université Laval, Pavillon Ferdinand-Vandry, Quebec City, Canada
Abstract
  • Abstract: Background: Consensus guidelines have recommended that decision aids include a process for helping patients clarify their values. We sought to examine the theoretical and empirical evidence related to the use of values clarification methods in patient decision aids. Methods: Building on the International Patient Decision Aid Standards (IPDAS) Collaboration’s 2005 review of values clarification methods in decision aids, we convened a multi-disciplinary expert group to examine key definitions, decision-making process theories, and empirical evidence about the effects of values clarification methods in decision aids. To summarize the current state of theory and evidence about the role of values clarification methods in decision aids, we undertook a process of evidence review and summary. Results: Values clarification methods (VCMs) are best defined as methods to help patients think about the desirability of options or attributes of options within a specific decision context, in order to identify which option he/she prefers. Several decision making process theories were identified that can inform the design of values clarification methods, but no single “best” practice for how such methods should be constructed was determined. Our evidence review found that existing VCMs were used for a variety of different decisions, rarely referenced underlying theory for their design, but generally were well described in regard to their development process. Listing the pros and cons of a decision was the most common method used. The 13 trials that compared decision support with or without VCMs reached mixed results: some found that VCMs improved some decision-making processes, while others found no effect. Conclusions: Values clarification methods may improve decision-making processes and potentially more distal outcomes. However, the small number of evaluations of VCMs and, where evaluations exist, the heterogeneity in outcome measures makes it difficult to determine their overall effectiveness or the specific characteristics that increase effectiveness.
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  • Article
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  • In Copyright
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  • Angela Fagerlin et al.; licensee BioMed Central Ltd.
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  • English
Is the article or chapter peer-reviewed?
  • Yes
Bibliographic citation
  • BMC Medical Informatics and Decision Making. 2013 Nov 29;13(Suppl 2):S8
Publisher
  • BioMed Central Ltd
Access right
  • Open Access
Date uploaded
  • August 17, 2015

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file details Clarifying values: an updated review (Article) 2019-05-06 Public Download
file details Additional file 3: Table S2: Characteristics of Values Clarification Methods and of The Studies in Which They were Presented 2019-05-06 Public Download
file details Additional file 5: Table S4: Outcomes Assessed in VCM Trials 2019-05-06 Public Download
file details Additional file 2: Appendix 1: Description of Selected Decision Processing Theories 2019-05-06 Public Download
file details Additional file 1: Table S1a: Decision Process Theories. Table S1b: Examples of Decision Processes in Decision Making about Prostate Cancer Treatment 2019-05-06 Public Download
file details Additional file 4: Table S3: Trials Examining Effect of a VCM vs. no VCM Within Decision Aids 2019-05-06 Public Download
file details Clarifying values: an updated review 2019-05-06 Public Download